are my syptoms Multiple Sclerosis?

[jimmylegs]

so re the folate question. you can have low b12, or you can have low b12 with anemia. same deal with folate.

whenever i get b12 tested, the doc would want to run a CBC at the same time to look at the hematological stuff and make sure the rbc count was high enough to rule out anemia

if someone is anemic, fixing either one of low b12 or low folate can correct the RBC count so it doesnt look like you have anemia any more. so if you're only looking at anemia as the indicator of your problem, and ignoring the levels of b12 or of folate, you can run into trouble in the long term, with deficiency of one or the other.

as a vegetarian you're much more likely to be fine for folate and not fine for cobalamin.
folate foods: http://www.whfoods.com/genpage.php?tnam ... #foodchart

although.. re folate utilization.. i just remembered something that answers one of your earlier questions. when i was just switching over from vegan to omni, but had not figured out my zinc deficiency yet, i could not handle b-complex supplements that had 1000ug of folic acid. i used to get phantom itching and it was super annoying. i got a folic acid blood test done to just check if my suspicion was right, and my level was NUTS. super super high. after getting fully switched over diet-wise, and zinc replete, i realized one day that my b complex had the same amount of folic acid that had bugged me before, but now it's no problem at all. another interesting wrinkle to that is that my mum had crazy itching through both her pregnancies, which is when people are most likely to be supplementing folic acid, and that means that she probably just didn't have enough zinc stores while she was pregnant. which also makes perfect sense, because building new human beings is a known drain on maternal zinc resources.

related post from last yr re folic acid and zinc interactions:
http://www.thisisms.com/forum/regimens- ... 9-555.html
Micronutrient interactions: effects on absorption and bioavailability
http://www.ncbi.nlm.nih.gov/pubmed/11509108
"... The polyglutamine forms of dietary folate require the conjugation by a zinc-dependent hydrolase prior to intestinal absorption. Zinc deficiency could consequently impair folate bioavailability."

zinc deficiency is an issue for vegetarians so that is one possible reason why you are reacting badly to b complex.

[chad]

Only been 2-3 years since I stopped eating meat. Growing up I was a 'meat and taters' kind of eater. Most of my issues have been around for about 9 years. This is when I herniated a disc in my back, and thought a lot of my symptoms were from that, as they onset around the same time. Things like abnormal nerve conduction tests, numb foot, slight rectal leakage. In fact I was sent to the ER for this, prepped for surgery (near my cauda equina) with morphine, then took an xray/mri to 'double check' before surgery, and they cancelled because it was 'this close' to requiring surgery. Finally 10 years later and I can say my back does not ache.

Couple more symptoms that come to mind are my slight bowel leakage and ringing in the ears. There's more I am forgetting but with so many 'little problems' I tend to forget about some.

Can't wait till Wednesday!

[jimmylegs]

i grew up meat and taters too - a really healthy diet BUT with too many anti-nutrient influences (stress, sports, lack of detailed nutrition knowledge) to have truly healthy intakes or status.

based on what i know re symptoms at this point, i would say i was low on iron, magnesium and zinc long before i was a vegetarian. it was a pretty long slow decline but when i really started paying attention, a lot of things turned around nicely.

looking forward to wednesday as well - you should get some useful info

[lyndacarol]

I'm also seeing debate of cyanocobalimin and methylcobalimin and a 3rd type of cobalimin. Any thoughts on which is best? I read that methylcobalimin is most effective for neurological issues?

From Could It Be B12? An Epidemic of Misdiagnoses by Sally Pacholok, RN, BSN, and Jeffrey Stuart, D.O.:

There are three forms of supplemental vitamin B12: cyanocobalamin, hydroxocobalamin, and methylcobalamin. (Page 223)

Some patients do well on monthly injections; however, many will do better with bi-monthly or even weekly injections. There is no harm in giving B12 more frequently.…
The old protocol of monthly injections is simply out of date and does not sufficiently benefit patients.… (Page 224)

Current evidence indicates that hydroxocobalamin is superior to cyanocobalamin, and methylcobalamin may be superior to hydroxocobalamin for neurologic disease. Lee notes in Wintrobe's Clinical Hematology, "The initial retention of hydroxocobalamin is better than that of cyanocobalamin; twenty-eight days after injection, retention still is nearly three times greater. In addition, hydroxocobalamin is more available to cells and is processed more efficiently by them." (Page 224)

Methylcobalamin (available at compound pharmacies, with or without preservatives) is not widely used in the United States, but Japanese studies indicate that it is even more effective in treating the neurological sequelae of B12 deficiency. Its greater efficacy presumably stems, at least in part, from the fact that, like hydroxocobalamin, it does not need to be decyanated. In addition, unlike either hydroxocobalamin or cyanocobalamin, it does not need to be reduced to the (+1) state (the only form that can cross the blood-brain barrier). … methylcobalamin is retained approximately three times longer in tissues than cyanocobalamin. (Page 225)

Recent research has found that patients with neurologic involvement may benefit even more from high-dose methylcobalamin. (Page 226)

[chad]

Alright guys results are in....I haven't looked yet, you get to look with me....

[chad]

Was scared to look....

Vitamin B12 = 239 pg/mL

Homocysteine = 9.4 umol/L

Folate = 19.3 ng/mL

[chad]

Based on the information I have at hand, I feel like you guys have SAVED MY LIFE!!! All the buttons on this keyboard pressed a million times could not portray how thankful I am to you guys!

[lyndacarol]

Was scared to look....

Vitamin B12 = 239 pg/mL

Homocysteine = 9.4 umol/L

Folate = 19.3 ng/mL

As I understand it, each lab has its own standard ranges for each test. You have not indicated what the standard ranges at your lab are; at my lab the standard ranges were

Serum B12……....213-816 pg/mL
Serum folic acid…. 7.0-31.4 ng/mL
Homocysteine…… 4.0-13.1 µmol/L

According to Could It Be B12?, on page 15, common reference ranges for the B12 serum test are:

211-911 pg/mL
180-914 pg/mL
200-1100 pg/mL

Many hospital labs consider a deficiency to be <200 pg/mL; borderline results to be 200-270 pg/mL.

The authors (Pacholok/Stuart) consider the Serum B12 Gray Zone to be 200-450 pg/mL (they consider the cutoff for deficiency to be too low); they "advocate B12 treatment in all symptomatic patients with serum B12 below 450 pg/mL." Elsewhere they put the cutoff at 550 pg/mL.

Certainly your vitamin B12 level qualifies for B12 treatment according to the authors. Although your homocysteine level is not skyhigh, it is in the upper half of my lab's range and in the upper half of another range I have found (4.0-12.0 µmol/L)

In my opinion, your test results certainly justify a discussion with your doctor about a therapeutic trial of B12 injections. If you do not need supplemental B12, it will not hurt you to take it. Make a thorough list of your symptoms and see if there is any improvement in any of them with a B12 injection. Let us know how it goes.

[NHE]

Was scared to look....

Vitamin B12 = 239 pg/mL

Homocysteine = 9.4 umol/L

Folate = 19.3 ng/mL

B12 is "definitely deficient." The reason I use quotes is because that's exactly what the doctor said to me when my level came out at 247. The range is 247-925 pg/mL.

The homocysteine is on the high side. The range is 4-12 µM. Mine was 16.1.

Folate might as well be nonexistent. The range is 499-1504 ng/mL. Mine was 403.

Just so you know, I'm now taking a sublingual B12 with folate. According to "Could It Be B12?" the combination was found to reduce homocysteine better than either B12 or folate taken separately.

[chad]

I will add more details of the tests shortly....

[chad]

B12 reference range: 247-911
Deficient: <212
Indeterminate: 212-246
Normal: 247-911

Homocysteine reference range: 4-12
(They didn't provide any info on what is normal or excessive here)

Folate reference range: 5.4-24.0
Deficient: <3.4
Indeterminate: 3.5-5.3
Normal: 5.4-24.0

[NHE]

Folate = 19.3 ng/mL

Folate might as well be nonexistent. The range is 499-1504 ng/mL. Mine was 403.

OK. The range I gave is for RBC folate, not serum folate.

19.3 ng/mL looks fine when compared to the range of 5.4-24.0 ng/mL.

[jimmylegs]

all right, so the veg diet being the most likely culprit for the low b12, how do you feel about working some salmon back into your diet? the omega 3s in salmon are important for vegetarians as well.

looking forward to seeing your zinc and mag results as well

in the meantime you should do well by meeting healthy dietary nutrition targets each day.

salmon is a great choice for b12 and omega 3, oysters are tops for zinc and also omega 3, and dark leafy greens like chard and spinach are amazing for magnesium

i have a young guy friend who was feeling crap, was a vegetarian, and he did not want to do bloodwork or take supplements. he had a nutrient poor diet and said he consumed too much alcohol. in fact one of his main complaints was not bouncing back from a big night as quickly as his friends.

i told him he had to start eating all the most nutrient dense foods he could think of, including lots of healthy fats from nuts seeds avocado etc. i also told him he was only allowed to have one piece of bread every other day, to avoid the nutrient drain. and hinted strongly that alcohol also would cause a significant drain on nutrient retention.

he took that advice to heart, commenting that he didn't know what to eat any more - that every time he went to the kitchen, he was looking for bread. he didn't know how to fill up. so i put him on complex carbs like sweet potato and brown rice.

he ran with it, and on that alone, his symptoms got better. he still plays with fire a bit, but at least he knows what to do to sort it out now. for the time being, the wheels are on

so, you have the bloodwork done - you're one up on my buddy so far good work

curious if you used that online service to order serum zinc and/or serum mag? if i had to choose one, given that you are vegetarian i would consider zinc the more pressing piece of info to acquire. hope you are having a good night!

[chad]

With much of my symptoms being present while I still ate plenty of meat as a child, would that not suggest my problem is more than dietary? 3 years without meat, 8 years since most symptoms, 16 years since initial symptoms.

Have you looked into hemp seed oil vs fish oil? From what I understand the hemp seed oil is superior, as it's fatty acids are in a more appropriate ratio for the body. It also contains the 'super' fatty acids that fish oil does not. I've seen it treat eczema molluscum with great results and when I take it regularly, my cracked feet get smooth. Also whenever my chest pains flare up, it's when I run out of the oil. When I get more, the chest pains subside. Great for some energy too.

So should I do the b12 rich food diet, then retest my blood after a couple months? And if it remains low, that would be telling of a more serious malabsorbtion issue?

I will be getting zinc/magnesium checked as soon as I can afford it.

[jimmylegs]

as we discussed before i had symptoms long before i went veg as well. you can have a bad diet causing issues to start with, and then make certain aspects of the overall problem even worse by taking out additional sources of nutrition.

i've used both seed and fish oils though not hemp specifically. i've seen arguments for both sides, eg long chain fatty acids are what your body needs and conversion from seed oil short chain EFAs is inefficient therefore long chain EFAs are best. either way, it's pretty easy to get too many omega 6s so just try to keep that ratio at about 1:1, whichever source you choose.

i'd look at increasing intakes of nutrient dense, on balance anti inflammatory foods, rich in b12 as well as omega 3, zinc, magnesium and every other cofactor. that way you will be most likely to optimize absorption and see a good result when you retest